From firstname.lastname@example.org Thu Jan 4 13:54:56 2001
Copyright 2001 InterPress Service, all rights reserved.
Growing Drug Use Pushes up HIV/AIDS Figures
By Richel Dursin, IPS, 2 jan 2000
JAKARTA, Jan 2 (IPS) - The number of people with HIV/AIDS in Indonesia has increased significantly due to rampant use of illegal drugs, officials here say.
Compounding worries is the fact that the sector of the population most at risk these days to the twin dangers of drugs and HIV/AIDS is the country's adolescents and young adults.
"Majority of the drug users are high school youths and early university students aged between 15 and 24 years old," says Dr. Amaya Maw- Naing, World Health Organisation (WHO) medical officer on sexually transmitted diseases and HIV/AIDS.
In Jakarta alone, at least 1,875 students from 318 junior and senior high schools are new drug users this year, data from the Ministry of Health show. But the real numbers of teenage drug users may be even higher, as many cases go undetected or are concealed to avoid public humiliation.
Maw-Naing notes that many of these youths are sexually active. Moreover, she says, "when they become addicted to drugs, they tend to need higher and higher doses and since they like a higher dose, they use heroin, which at a lower dose gives them a quick high".
Indeed, heroin -- known locally as 'putauw' -- is one of the top two substances of choice of half of Indonesia's estimated 3.1 million drug users. Like their other 'favourite', crystal methamphetamine or 'shabu-shabu', heroin is injected.
Unfortunately, says Sigit Priohutomo, chief of the guidance section of the AIDS and STD control programme of the Ministry of Health and Social Welfare, many of the country's drug users "do not know the risks of sharing syringes", which are relatively expensive but can be easily bought from pharmacies.
The health ministry estimates that at least 60 percent of Indonesia's drug users share syringes, a key mode of transmission of blood- transmissed illnesses.
One result of this is that "the reported cases of AIDS due to intravenous drug use in Indonesia have increased sevenfold in 2000", Priohutomo says. He also reports, "At least 37.5 percent of AIDS and 73.3 (percent of) HIV cases discovered in November 2000 alone involved drug users."
Of the eight AIDS cases reported in November, three had injecting drug use as the mode of HIV transmission. Meanwhile, here in Jakarta, 22 or 73.3 percent of the 30 HIV infections recorded from Jan. 1 to Nov. 30, 2000 involved drug use.
At present, injecting drug use is the second major mode of transmission of HIV in Indonesia, after unprotected sex.
Of the "official" count of 1,559 HIV/AIDS cases -- although the WHO estimate is much higher than this -- government officials say 54.26 percent had heterosexual sex as the mode of transmission.
Authorities and health workers, however, have become most alarmed by the fact that at least 15 percent of the drug users throughout the country have HIV. (Almost 80 percent of the drug addicts have also been infected with hepatitis B and hepatitis C.)
According to a World Bank report issued in November, injecting drug use is increasing in South-east Asia due to cheap heroin supplies, deepening poverty and social desperation following the 1997 economic crisis, and a lack of effective law enforcement.
Comments AIDS activist Chris Green: "Not only does the virus spread among intravenous drug users who share needles, but it will spread from them to their sexual partners (including sexual workers) and onward to their children during birth or breast feeding."
Officials say that while Indonesia's HIV/AIDS prevalence -- 0.2 per 100,000 people -- is still relatively low compared to other countries in the region, measures to prevent the spread of the deadly disease must be intensified.
Says Haikin Rachmat of the Ministry of Health and Social Welfare: "(The) coverage and intensity of its prevalence and control need to be increased because risk behaviour does exist in the country."
He points out, "The available HIV and behavioural data as well as the high prevalence of syphilis suggest the potential for an alarming increase in HIV transmission and the need for intensified preventive efforts."
But he also concedes that "prevention and control activities for AIDS among high-risk groups are much more difficult to be implemented" these days.
For instance, special locations for brothels are no longer accepted by local communities, making it harder for the government and activist groups to track sex workers and educate them on HIV/AIDS.
Indonesia's prolonged economic crisis is another obstacle. As it is, officials note that previous preventive efforts carried out by the government and other groups among high-risk groups have borne little fruit due to limited financial resources.
In addition, Priohutomo says, "it is very difficult for us to change the thinking and culture of people.
The WHO office here, for example, is calling on the government to push 100 percent condom use in entertainment areas. Yet officials of the agency themselves admit that condom use is not culturally accepted in predominantly Muslim Indonesia. Says Maw-Naing: "Condom use is considered an insult to Islam."
Others note that that while Indonesia had its first HIV/AIDS case reported in 1987, there are still health officials unfamiliar with it and many hospitals are not ready to serve people with HIV.
[c] 2001, InterPress Third World News Agency (IPS)
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